Provider Demographics
NPI:1629499926
Name:KANTAR, MELISSA ANN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:KANTAR
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2202
Mailing Address - Country:US
Mailing Address - Phone:718-638-9617
Mailing Address - Fax:718-398-6631
Practice Address - Street 1:159 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2202
Practice Address - Country:US
Practice Address - Phone:718-638-9617
Practice Address - Fax:718-398-6631
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20058734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist